Active NPI
Lafrancine Wells-Bradford, LMFT
- Marriage & Family Therapist
- Valdosta, GA
National Provider Identifier
1619262300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001200
- Practice address
- 3120 N Oak Street Ext Ste C
Valdosta, GA 31602-5910 - Phone
- (229) 671-6100
- Fax
- (229) 671-6774
- NPI assigned
- Jun 10, 2011
- Last updated
- Jun 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001200 | GA | Primary |
Addresses
Primary practice location
3120 N Oak Street Ext Ste C
Valdosta, GA 31602-5910
Mailing address
3120 N Oak St
Valdosta, GA 31602-1003
Phone (229) 671-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001200 | Other | GA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001200 | GA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1619262300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3120 N OAK ST",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316021003",
"telephone_number": "229-671-6100",
"fax_number": "229-671-6761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3120 N OAK STREET EXT STE C",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316025910",
"telephone_number": "229-671-6100",
"fax_number": "229-671-6774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS-BRADFORD",
"first_name": "LAFRANCINE",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-10",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "001200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "001200",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.